Just*in Time: January 2015

I came across your video on the OraQuick In-Home HIV Test. I took this test three times after my possible exposure. My risk was getting a blow job from a HIV-positive woman from Africa. The whole act was about five minutes with no ejaculation. I took in-home tests on the following days after sex with these results:

• 84 days: Negative
• 102 days: Negative
• 126 days: Negative
I heard that the test has a high rate of false negatives. Is that true?

Do you think I can trust that I do not have HIV with these results?

I’m asking because I’ve been having some weird symptoms from seven weeks after exposure non-stop up till today, about nineteen weeks later. The symptoms are tingling and pain in muscles and feet, headache, feeling like my body is overheated, fatigue, feeling ill, etc. I don’t want to take a blood test here because I’m in a small town in the Midwest where racists are everywhere. (I’m an African American.) Sorry to trouble you, and please respond back. Thank you.
—Niko

Thank you so much for e-mailing me. Let me first thank you for being proactive in your own health. I stand by and believe in the OraQuick In-Home HIV Test just as long as you know where to link to and receive resources in case the test comes up positive. Note that OraQuick provides a toll-free and confidential 24/7 support center at 1 (866) 436-6527 that will link you to services, and it also has resource finders on its Web site.

Back to your question about false negatives: Investigators found that ninety-two percent of people who are HIV-positive received a positive test result. This is called the “sensitivity” of the test. The researchers also found that 99.98 percent of the people who were HIV-negative received a negative test result; this is called the “specificity” of the test. All in all, I think that you can trust the test, but keep in mind that it takes up to a little over three weeks for HIV antibodies to show up in your system and thus for HIV to be detected by a rapid test. (An RNA test can detect HIV much earlier, but that is not a usual test unless you make a point of telling your physician that you believe that you have been exposed to HIV.) So that is why I usually advise someone who is sexually active to get tested once every three months, so therefore you have your bases covered. Also, when you do go to your primary care physician for a check-up, it’s best to see if you can get tested for everything else. I know you don’t want your doctor to test you for HIV, but you have to keep in mind the sexually transmitted infections (STIs) other than HIV. Your “weird” symptoms might be the result of something other than HIV, but you won’t know without consulting your doctor.

Let me first start by saying that, yes, I consider oral sex a form of sex in which bodily fluids are exchanged. However, the risk of HIV transmission through oral sex is much less than that from vaginal or anal sex. In this context, the riskiest practice is performing oral sex on an HIV-infected man, with ejaculation in the mouth. According to the Centers for Disease Control and Prevention, there are also some factors that might increase the risk of HIV transmission during oral sex, such as oral ulcers, bleeding gums, genital sores, and the presence of other STIs.

Now that I’ve answered your basic questions, and since the New Year is coming up, I’m going to ask you to make a resolution to yourself. Your New Year’s resolution, should you choose to make it, is to get tested every three to six months using whatever method you would like. This means that you have to start getting tested as a part of your personal regimen.

Now I understand you’re in a small town in the Midwest where mentalities can be different, not just based on race but other factors as well. But keep in mind the important thing is your health—not anyone’s opinion. I would suggest finding a doctor in another town or at least stick with the OraQuick test. I know you are scared, but I would use a calendar strategy. Mark on your calendar every three to six months that you need to order the test, to make sure you don’t forget.

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Justin B. Terry-Smith, MPH, has been fighting the good fight since 1999. He’s garnered recognition and awards for his work, but he’s more concerned about looking for new ways to transform society for the better than resting on his laurels. He started up in gay rights and HIV activism in 2005, published an HIV-themed children’s book, I Have A Secret (Creative House Press) in 2011, and created his own award-winning video blog called, “Justin’s HIV Journal”: justinshivjournal.blogspot.com. Now, with this column, Justin has found a way to give voice to the issues that people write to him about. Visit his main Web site at www.justinbsmith.com. He welcomes your questions at [email protected].

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